What Is Gingival Hyperplasia? Causes, Treatment, and More

Medically Reviewed By Christine Frank, DDS
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Gingival hyperplasia refers to the overgrowth of the gingival tissues of the gums. This can impair oral and dental health. It can occur for many reasons, including plaque buildup, side effects from medications, and certain underlying conditions. The term hyperplasia refers to when the number of cells in an organ or tissue increase, leading to an enlargement of the body part. Some may refer to the condition as “gingival enlargement or gingival hypertrophy”.

With gingival hyperplasia, the overproduction of cells occurs in the gums, resulting in excess gum tissue that may start to cover the teeth.

Cases of gingival hyperplasia can range from mild to severe. In more severe cases, gum tissue can cover up the teeth, leading to improper oral hygiene or interference with tooth development and alignment. 

This article will explain gingival hyperplasia, including its symptoms and causes. We’ll also discuss treatment, complications, and outlook of the condition.

What are the symptoms of gingival hyperplasia?

A child and an adult stand side by side while brushing their teeth.
YakobchukOlena/Getty Images

The enlargement of the gums can be local, remaining in limited areas, or general, being more widespread in the mouth.

Symptoms of gingival hyperplasia include:

  • lesions or growths that may be red or white in color, or the same as the typical color of your gums
  • gum inflammation or swelling
  • gums which bleed easily 
  • pain or tenderness in the gums 
  • buildup of tooth plaque 
  • pain when eating or chewing 
  • halitosis, bad breath
  • gums that partially or almost completely cover the teeth 

However, a 2018 study of 1,1187 localized gingival enlargements observed that 82% of cases were asymptomatic. This means that gingival hyperplasia may not always cause noticeable symptoms.

Below are some examples of what hyperplasia may look like.

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Overgrowth of the gums can cover the teeth. It may also cause redness or discoloration, tenderness, and other symptoms of inflammation.

Lesion, CC BY-SA 3.0, via Wikimedia Commons

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Sometimes, gingival hyperplasia can completely cover the teeth, preventing the eruption of secondary or "adult" teeth in children.

"Bien Lai, Joseph Muenzer, and Michael W. Roberts, “Idiopathic Gingival Hyperplasia: A Case Report with a 17-Year Followup,” Case Reports in Dentistry, vol. 2011, Article ID 986237, 5 pages, 2011. doi:10.1155/2011/986237. CC0 1.0 Universal (CC0 1.0) Public Domain Dedication."

What causes gingival hyperplasia?

Gingival hyperplasia can have multiple causes, which vary depending on how they lead to the development of hyperplasia.

Sometimes gingival hyperplasia can be idiopathic, meaning clinicians are not sure why it occurs. However, idiopathic gingival hyperplasia is rare.

Plaque-induced inflammation

According to a 2017 overview, gingival hyperplasia most commonly occurs due to the buildup of plaque. This buildup causes inflammation which can cause an overgrowth of the gingival tissue.

Plaque buildup may occur due to improper oral hygiene, including brushing and flossing the teeth. 

Drug-induced gum enlargement 

Certain types of medications may cause cell growth in the gum tissue as a side effect, leading to gingival hyperplasia.

Examples of such medications include:

  • anti-seizure drugs, such as phenytoin
  • immunosuppressants, such as cyclosporine and tacrolimus
  • calcium channel blockers, such as nifedipine and amlodipine

According to a 2021 overview of drug-induced gingival hyperplasia, medications are the most common cause of gingival hyperplasia. 

Heredity gum fibromatosis

Some rare genetic conditions can also lead to gingival hyperplasia. Such conditions can include hereditary gingival fibromatosis and neurofibromatosis.

Hereditary gingival fibromatosis is a rare and noncancerous genetic condition that causes slow, progressive gingival hyperplasia. It can delay the eruption of teeth in children, which may cause both aesthetic and functional differences.

Neurofibromatosis is a genetic condition that causes tumors to grow in the cells of the nerves. This can include causing growth in the gums. While some cases can lead to complications, many cases of neurofibromatosis do not significantly affect quality of life.

Systemic causes 

Certain systemic conditions can also lead to gingival hyperplasia. This means that conditions that stem from other body systems or conditions may affect the gums.

Additionally, other factors may trigger plaque buildup or inflammation that leads to or exacerbates gingival enlargement.

These causes can include:

Inflammation that leads to overgrowth can also occur due to dental and oral conditions or factors such as:

  • infection
  • abscesses
  • pericoronitis
  • wearing dentures or implants
  • the use of clinical dental appliances
  • plasma cell gingivitis
  • fibrous epulis

Gingival hyperplasia and leukemia

Leukemia can cause symptoms that affect the mouth. In fact, the 2017 overview reports that 33% of people with acute leukemia experienced gingival enlargement.

As researchers suggest that gingival symptoms such as bleeding and spots, swelling, or hyperplasia may be the first noticeable signs, contact your doctor promptly if you notice any gum changes or symptoms. You may also experience lethargy, infections, or night sweats alongside these changes. Reporting these symptoms promptly can help you to receive early diagnosis and effective treatment.

However, hyperplasia may not always indicate leukemia or other cancer. For instance, the 2018 study reports approximately 1% of cases of localized gum enlargements are malignant, meaning cancerous.

How do doctors diagnose gingival hyerplasia?

Some conditions can cause gingival swelling without leading to tissue overgrowth. As a result, diagnosis is important to identify the symptoms and underlying cause to provide you with the most effective treatment.

A dentist may be able to diagnose gingival hyperplasia by asking about your full medical history and performing an oral exam.

Some cases may require consultation with a doctor and/or additional diagnostic tests to identify the cause, depending on the underlying condition. These tests can include blood tests or a biopsy.

How do you treat gingival hyperplasia?

Doctors will focus on resolving the underlying cause of gingival hyperplasia in order to treat the condition.

For example, if medication caused hyperplasia as a side effect, a doctor may recommend changing your medication routine. However, if you suspect that your hyperplasia is medication-induced, it is important to continue to take medication as instructed until your doctor revises your treatment plan.

If plaque-induced inflammation is the cause, gingival hyperplasia may improve with proper oral hygiene, including regular brushing and flossing. 

Additional treatment approaches can include:

  • controlling plaque through proper oral hygiene and regular dental cleanings 
  • using medications such as:
    • nonsteroidal anti-inflammatory drugs, such as ibuprofen
    • antibiotics
    • topical antifungal medications
    • nutritional supplements 
  • surgery, such as a gingivectomy to remove gum tissue

Sometimes gingival hyperplasia may recur, developing again after successful treatment. In severe cases that impede the function of the teeth or cause discomfort, or if the gingival hyperplasia recurs or persists, doctors may recommend surgery to remove the excess gum tissue. 

How do you treat gingival hyperplasia at home?

Taking good care of your teeth and gums may help prevent exacerbating gingival hyperplasia and reduce the risk of complications.

The Centers for Disease Control and Prevention (CDC) notes that proper dental and oral health includes:

  • brushing your teeth twice a day with a toothpaste that contains fluoride
  • seeing your dentist for oral exams and cleanings
  • eating a balanced diet low in added sugar and acidic foods 
  • limiting smoking and tobacco  
  • limiting alcohol consumption

What are the potential complications of gingival hyperplasia?

Some possible complications of gingival hyperplasia include:

  • functional impairments of the mouth and teeth
  • aesthetic concerns
  • increased risk of cavities
  • delays in the eruption of secondary or “adult” teeth in children
  • prolonged primary dentition, whereby children have their primary teeth for longer than usual
  • drifting of the teeth or gaps and spacing conditions
  • buildup of plaque, which may lead to further gum and dental conditions
  • pain or discomfort

Learn more about cavities, including their symptoms, prevention, and treatment.

What is the outlook for gingival hyperplasia?

Some causes of gingival hyperplasia can be resolved, depending on the underlying condition.

For example, in some cases of drug-induced hyperplasia, changing medication routines may lead the gingival tissue to return to how it was before.

Plaque control can also help reduce complications and improve the outlook of your condition.

Some conditions, however, may require more intensive treatment to improve gum health and resolve any resulting complications. Additionally, some underlying conditions such as cancer or Crohn’s disease may cause other significant impacts on health that can affect outcomes.

Additionally, some cases of hyperplasia recur after surgical treatment.

Contact your doctor to discuss what you can expect from your condition and treatment plan.

Summary

Gingival hyperplasia is the abnormal growth of excessive gum tissue that can cover the teeth, possibly interfering with tooth alignment and leading to impaired oral hygiene. Other symptoms can include pain, swelling, and bleeding of the gums.

Gingival hyperplasia can happen due to various causes, including plaque buildup or oral inflammation, side effects from medication, and systemic conditions such as Crohn’s disease. Treating the underlying cause of gingival hyperplasia can help resolve the condition.

If you suspect you have gingival hyperplasia, contact a dentist right away for an oral exam.

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Medical Reviewer: Christine Frank, DDS
Last Review Date: 2022 Sep 27
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